Reliability of rotary prism fusional vergence ranges.

BACKGROUND: The measurement of fusional vergence ranges is an important clinical test in the assessment of binocular vision status. Fusional vergence ranges are typically measured by recording a patient's reports of blur, break, and recovery to base-in (BI) and base-out (BO) prism. Published reliability data on fusional vergence ranges are very limited. METHODS: Eight subjects underwent four testing sessions, at which repeated measurements of fusional vergence ranges were taken. Near ranges were tested at the first session only Distance ranges were tested at all four sessions. Intra-examiner standard deviations were calculated for each fusional vergence test result (BI and BO; blur, break, and recovery) for each session. Intra-examiner standard deviations were averaged. These values were used to determine 95% limits of agreement. RESULTS: The 95% limits of agreement were between 2 delta and 2.5 delta for the distance BI break and recovery and for the near BI recovery; between 3 and 4 delta for near BI break and near BO break; between 4 and 5 delta for distance BO blur and recovery and for near BI blur; and between 5 and 5.5 delta for distance BO break and near BO blur and recovery.

A comparison of three subjective tests for astigmatism and their interexaminer reliabilities.

BACKGROUND: Astigmatism is a common cause of blurred vision and asthenopia. Several different tests for the measurement of astigmatism have been described in the literature, but there are few studies that have compared the results of various tests. METHODS: The results of three astigmatism tests performed on 40 subjects by two examiners were compared. Two of the tests, the Jackson cross cylinder (JCC) and the Humphriss immediate contrast (HIC), utilized distance targets; one test, the Pratt test, involved a near target. RESULTS: The mean differences between all tests were less than 0.25D. There was a slight tendency for higher cylinder power to be found on the Pratt test. The three tests agreed within +/- 0.25D on cylinder power 80 to 98 percent of the time and within 10 degrees of cylinder axis 85 to 98 percent of the time. Interexaminer reliability showed mean differences less than 0.12D for each of the three tests, agreement within +/- 0.25D on cylinder power 88 to 90 percent of the time and within 10 degrees on cylinder axis 85 to 93 percent of the time. CONCLUSIONS: The results suggested that any of the three techniques could be substituted for another for astigmatism testing. On theoretical grounds, a binocular refraction method for cylinder axis determination, such as the HIC, is advisable for patients with cyclophorias and significant amounts of astigmatism. The results showed good reliability for each of the three methods.

The effect of color on light-induced seizures: a case report.

BACKGROUND: Two to four percent of epileptics have their seizures triggered by flickering light, an effect which may be wavelength-dependent. We evaluated a patient with a long-standing history of light-induced petit mal seizures to determine if the seizures were triggered more effectively by a particular range of wavelengths and to determine whether this information could be used in the optometric management of such patients. METHODS: Flickering lights of different wavelengths but equal luminance were presented while the patient's electroencephalogram (EEG) and subjective reports were monitored. RESULTS: The EEG results were not significantly different for different wavelengths, but the patient reported that longer wavelength light induced stronger seizures more consistently. Based on these results we concluded that the patient might benefit from spectacles tinted to exclude transmission of red light. The patient was given 4 pairs of 85% transmission spectacles, which differed only in lens tint (red, yellow, green, and blue), to try over a period of time. The patient felt that the tinted lenses were not dark enough to decrease his seizures effectively and he has opted to wear standard sunglasses. CONCLUSIONS: We feel this case shows that patients with light-induced seizures can benefit from optometric consultation. Because the patient's subjective report identified the clearest wavelength effect, we feel that it is reasonable for the general practitioner to suggest deeply tinted lenses to reduce the frequency of seizures in these patients.

Optometric education and optometry in Africa.

BACKGROUND: For the vast majority of people in Africa, eye care services are not available. Optometrists have long been practicing in parts of Africa, but optometric teaching institutes have only recently appeared in several African nations. METHODS: Utilizing interviews, site visits, and a literature review this article presents a survey of the current status of optometric education, the profession of optometry, and eye care needs in Africa. RESULTS AND CONCLUSIONS: Four countries in Africa have optometric teaching institutes: South Africa, Nigeria, Tanzania, and Ghana. Most of these programs are struggling in difficult economic and/or political environments. The difficulties facing these programs are likely to remain, but the recent dramatic developments in communication and cooperation between these four countries will be a positive force towards seriously addressing the need for more optometric practitioners throughout the African continent.

The expanding scope of practice and the optometric curriculum.

The expansion of the scope of optometric practice has put tremendous pressures on the curricula of the optometric teaching institutions. The pressures and the solutions that have been proposed in the optometric literature are outlined. The possibility of eliminating portions of the curriculum that have traditionally been regarded as the educational foundation of the practice of optometry and what effect this would have on the very definition of the term "optometry" is discussed.

Discrimination of visual motion from flicker by identified neurons in the medulla of the fleshfly Sarcophaga bullata.

1. Responses to moving contrast gratings and to flicker have been studied in cells in the medulla of the fleshfly Sarcophaga bullata using intracellular recordings and stainings. Medullary neurons responded periodically to flicker. Those which primarily discriminated motion had periodic responses or DC shifts in membrane potentials or increased noise. Intrinsic neurons included a T1a cell which was directionally selective (DS) and specific non-DS amacrine cells (6 types) arborizing either distal or proximal to the serpentine layer. Among the 12 types of output neurons recorded, 1 projected to the lobula plate, 6 to the lobula (Tm and T2 cells). 3 to both the lobula and lobula plate (Y cells), and 2 to the central brain. 2. Irrespective of their projection, medulla neurons which arborize in the stratum of the L2 terminals respond to flicker as does L2 and have the simplest, primarily periodic, responses to motion. The responses have significant power at the second harmonic of the stimulus temporal frequency suggesting that a non-linear operation, such as multiplication, may occur in the L2 stratum. Cells with arbors coinciding with either of the two levels of L1 terminals have much more complex responses to motion. All cells projecting to the lobula plate responded periodically to movement in some direction(s).